Facial nerve, the seventh cranial nerve, is mixed. It consists of two parts. The largest branch is formed by motor fibers originating from the nucleus located in the upper part of the rhomboid fossa. Then it exits at the cerebellopontine angle and enters the internal auditory canal, from where it passes into the facial canal of the temporal bone. It then leaves the temporal bone through the stylomastoid foramen and enters the parotid gland, forming a plexus in it. From this plexus, the branches of the facial nerve fan out to the muscles of the face and neck. Each of which is responsible for the movements of the eyelids, facial muscles, lips (orbicularis oris muscle - stretching the lips, closing the mouth; orbicularis oculi muscle - squinting the eyes; buccal muscle - tension of the cheeks; occipital, frontal - wrinkling of the forehead; laughter muscle - abduction of the corner of the mouth; zygomaticus major muscle - raising the corner of the mouth), and also innervates the occipital, stylohyoid, posterior belly of the digastric muscle, subcutaneous neck muscle and stapes muscle, involved in hearing.
This branch is accompanied by a thinner one - the intermediate nerve - which contains autonomic, gustatory and secretory fibers involved in the perception of taste from the anterior 2/3 of the tongue, as well as the secretion of tears, saliva and sweating.
The branches of the facial nerve form connections with the branches of the trigeminal, glossopharyngeal, vagus nerves and cervical plexus.
The complexity of the anatomical structure and location of the facial nerve, the multiplicity of anatomical connections determine the diversity pathological manifestations that arise when it is damaged at various levels. Highest value has peripheral facial paralysis syndrome (lesion in the cranial cavity, bone canal or at the site of its exit from the temporal bone canal).
Schematic representation of the topography of the branches of the facial nerve: 1 - greater petrosal nerve; 2 - ganglion of the knee; 3 - stapedius nerve; 4 - drum string; 5 - temporal branches; 6 - zygomatic branches; 7 - buccal branches; 8 - marginal branch lower jaw; 9 - cervical branch; 10 - parotid plexus; 11 - stylohyoid branch; 12 - digastric branch; 13 - stylomastoid foramen; 14 - posterior auricular nerve.
Characteristic signs of facial nerve damage are:
- facial asymmetry, the face “sags” on the side of the injury
- smoothing the folds of the forehead and mouth
- drooping eyebrow
- drooping corner of the mouth
- inability to move the facial muscles and lips on the injured side
- inability to completely close the eye
- widening of the palpebral fissure
- ectropion of the lower eyelid, varying degrees of severity
If the nerve is damaged before the branch (greater petrosal nerve) leaves from it, which innervates the lacrimal gland, glands of the mucous membrane of the nasal cavity and palate, on the affected side, in addition to the above symptoms, occurs
- dry eyes
- sweating disorder
- taste disturbances
- dry mouth
- hearing loss - a sharp, unpleasant increase in the perception of sounds
Most often this occurs during operations for neuroma of the VIII cranial nerve (acoustic neuroma).
In the event that the damage occurs further than the origin of this branch, lacrimation occurs, which is associated with the preserved secretion of the lacrimal glands with incomplete or incorrect position of the lower eyelid and lacrimal punctum.
However, if the palpebral fissure is not fully closed, this does not prevent the eye from drying out, especially at night, when tear secretion is physiologically reduced.
Central paralysis of the facial muscles occurs when the corticonuclear tract is damaged on the side opposite to the paralysis, while only the lower half of the facial muscles suffers, the function of the muscles of the eye and eyebrow is preserved, which determines the differential diagnosis with peripheral damage to the facial nerve.
Patients with acute paresis of the facial nerve require consultation with a neurologist as soon as possible, since in most cases it is possible to avoid complications during treatment.
Facial neuritis or Bell's palsy– this is inflammation of the 7th pair of cranial nerves, or rather one of them. The disease deprives a person of the ability to control his face and show emotions: frown, smile, raise his eyebrows in surprise, and even chew food normally. The face looks asymmetrical and skewed.
The facial nerve is most often affected. This is due to the fact that on its way it passes through the narrow canals of the facial bones. Therefore, even minor inflammation leads to constriction and oxygen starvation, which causes symptoms of the disease. For most people, the facial muscles on one side of the face fail. But in 2% of people, inflammation occurs on both sides.
Facial neuritis is a fairly common disease. Every year, 25 people per 100 thousand of the population suffer from this disease. Both men and women are equally susceptible to it. A surge in the disease is observed during the cold season. There are especially many patients in the northern regions.
Neuritis of the facial nerve is characterized by a protracted course. You will have to spend an average of 20-30 days in the hospital. Full recovery will take 3-6 months. But, unfortunately, in 5% of people the function of the facial muscles is not restored. This happens if facial neuritis is caused by a brain tumor or traumatic brain injury. And in 10% of cases, after recovery, a relapse occurs.
The severity of the disease and recovery time depend on which part of the nerve is damaged, to what depth and how quickly treatment was started.
Anatomy of the facial nerve
The facial nerve is primarily motor and regulates the facial muscles. But it contains fibers of the intermediate nerve. They are responsible for the production of tears and saliva by the glands, as well as the sensitivity of the skin and tongue.The nerve trunk itself is long shoots nerve cells-neurons. These processes are covered on top with a membrane (perineurium), consisting of special cells called neuroglia. If the nerve sheath is inflamed, then the symptoms of the disease are mild and they are not as numerous as when neurons are damaged.
What does the facial nerve consist of:
- area of cortex brain, which is responsible for facial expressions;
- The nuclei of the facial nerve are located on the border of the medullary pons and the medulla oblongata.
- nucleus of the facial nerve – responsible for facial expressions;
- nucleus of the solitary tract - responsible for the taste buds of the tongue;
- superior salivary nucleus - responsible for lacrimal and salivary glands.
- The motor processes (fibers) of nerve cells are the nerve trunk.
- a network of blood and lymphatic vessels - capillaries penetrate the nerve sheath and are located between the processes of nerve cells, providing them with nutrition.
As you can see, the facial nerve makes a tortuous path and passes through narrow channels and openings. If it becomes inflamed and swollen, the nerve fibers increase in volume. In narrow areas, this can lead to compression and destruction of nerve cells.
Causes of neuritis of the facial nerve
Scientists have not been able to definitively establish the cause of the disease. A number of factors have been associated with inflammation of the facial nerve.- Herpes virus. This virus lives in the body of most people and does not betray its presence in any way. But when immunity declines, the virus actively multiplies. His favorite place is nerve fibers. The herpes virus causes inflammation and swelling of the nerve. It is believed that the disease can also be caused by mumps viruses, polio viruses, enteroviruses and adenoviruses.
- Hypothermia . Hypothermia of the body leads to decreased immunity. In the case of neuritis of the facial nerve, local hypothermia is especially dangerous. For example, you were in a draft for a long time. In this case, spasm of blood vessels and muscles occurs, which contributes to disruption of nerve nutrition and inflammation.
- Taking large doses of alcohol . Ethanol- poison for nervous system. It affects not only the brain, but also causes inflammation of the nerves.
- High blood pressure. Hypertension can lead to increased intracranial pressure. In this case, the nuclei of the facial nerve are affected. Besides high blood pressure may cause a stroke. If the hemorrhage occurs near the facial nerve, it will also be affected.
- Pregnancy . In this regard, the first trimester is especially dangerous. During this period, serious events occur in the woman’s body. hormonal changes that affect the nervous system.
- Brain tumors. It's pretty rare reason neuritis, but it should not be ruled out. The tumor compresses the nerve and disrupts the conduction of nerve impulses.
- Open or closed head injuries, ear injuries . The blow causes damage or rupture of nerve fibers. Fluid accumulates in this area, swelling and inflammation spread throughout the nerve.
- Unsuccessful treatment at the dentist . Past stress, infection from carious cavity or mechanical trauma to the nerve endings can cause inflammation.
- Past otitis and sinusitis . Diseases of the ENT organs caused by viruses or bacteria can spread to surrounding tissues or cause compression of the nerve in the temporal bone canal.
- Diabetes . This disease is accompanied by metabolic disorders, which leads to the appearance of foci of inflammation.
- Atherosclerosis . The capillaries that supply blood to the nerve become clogged with fatty plaques. As a result, the nerve starves and its cells die.
- Stress and depression . Such conditions undermine the health of the nervous system and the body's defenses as a whole.
- Multiple sclerosis . This disease is associated with the destruction of the myelin sheath of nerve fibers and the formation of plaques in their place. Such processes often cause inflammation of the optic and facial nerves.
The mechanism of development of neuritis of the facial nerve.
These factors lead to spasm (narrowing) of the arteries. In this case, the blood stagnates in the capillaries, and they expand. The liquid component of the blood penetrates the capillary wall and accumulates in the intercellular spaces. Swelling of the tissue occurs, as a result of which the veins and lymphatic vessels are compressed - the outflow of lymph is disrupted.This leads to disruption of the blood circulation of the nerve and its nutrition. Nerve cells are very sensitive to lack of oxygen. The nerve trunk swells and hemorrhages appear in it. This leads to the fact that nerve impulses are poorly transmitted from the brain to the muscles. The command given by the brain does not travel through the fibers, the muscles do not hear it and are inactive. All signs of the disease are associated with this.
Symptoms and signs of facial neuritis
Neuritis of the facial nerve always has an acute onset. If symptoms appear slowly, this indicates another pathology of the nervous system.| Symptom | Its manifestations | Cause | Photo |
| 1-2 days before the disturbance in facial expressions, pain appears behind the ear. | The pain can radiate to the back of the head and face. After a few days, the eyeball begins to hurt. | Unpleasant sensations caused by swelling of the nerve. It is compressed at the exit from the auditory opening of the temporal bone. |  |
| The face is asymmetrical and resembles a mask on the affected side. | The eye is wide open, the corner of the mouth is lowered, the nasolabial fold and folds on the forehead are smoothed. The asymmetry becomes more noticeable when talking, laughing, or crying. | The brain loses the ability to control the facial muscles of one side of the face. |  |
| The eye on the affected side does not close. | When you try to close your eyes, the eye on the affected side does not close, and the eyeball turns upward. A gap remains through which the white membrane of the hare's eye is visible. | The orbicularis oculi muscle is poorly innervated. The muscles of the eyelid on the affected side do not obey. |  |
| The corner of the mouth droops. The mouth becomes like a tennis racket with the handle turned towards the affected side. | When eating, liquid food pours out from one side of the mouth. But at the same time, the person retains the ability to move the jaw and chew. | The buccal branches of the facial nerve cease to control the orbicularis oris muscle. |  |
| The cheek muscles do not obey. | While eating, a person bites his cheek and food constantly falls behind it. | The facial nerve does not transmit brain signals to the cheek muscles. |  |
| Dry mouth. | Constant thirst, feeling of dry mouth, while eating food is not sufficiently moistened with saliva. But in some cases, excessive salivation occurs. Saliva runs in a stream from the lowered corner of the mouth. | Salivary gland receives distorted commands from the brain. |  |
| Speech becomes slurred. | Half of the mouth is not involved in the articulation of sounds. Noticeable problems arise when pronouncing consonant sounds (b, v, f). | The facial nerve supplies the lips and cheeks, which are responsible for the pronunciation of sounds. |  |
| Dryness of the eyeball. | Doesn't stand out sufficient quantity tears, and the eye is wide open and rarely blinks. This causes it to dry out. | The functioning of the lacrimal gland is disrupted; it produces an insufficient amount of tear fluid. |  |
| Tearing. | For some people the situation is the opposite. Tears are produced in excess. And they, instead of going into the tear duct, flow down the cheek. | Active work of the lacrimal gland, disruption of the outflow of tears. |  |
| The perception of taste on one half of the tongue is impaired. | The anterior 2/3 of the tongue on the affected side of the face cannot taste food. | This is caused by inflammation of the nerve fibers that carry signals from the taste buds on the tongue to the brain. |  |
| Increased hearing sensitivity. | Sounds on one side seem louder than they actually are. This is especially true for low tones. | The facial nerve is inflamed in the temporal bone near the auditory receptors, which affects their function. The nucleus of the facial nerve is located next to the nucleus of the auditory nerve. Therefore, inflammation affects the functioning of the auditory analyzer. |  |
Based on the symptoms of the disease, an experienced doctor can determine exactly where the lesion has occurred on the facial nerve.
- Damage to the cerebral cortex which is responsible for the facial nerve - paralysis of the facial muscles of the lower half of the face, nervous tics, involuntary movements of the facial muscles. When laughing and crying, the asymmetry is not noticeable.
- Damage to the facial nerve nuclei – involuntary rapid movements of the eyeballs (nystagmus), a person cannot wrinkle his forehead, decreased sensitivity of the skin on half of the face (numbness), frequent twitching of the palate and pharynx occurs. Impaired coordination of movements in the entire half of the body may occur.
- Damage to the facial nerve in the cranial cavity and in the pyramid of the temporal bone – paralysis of facial muscles, salivary glands do not produce enough saliva, dry mouth, the front part of the tongue does not feel taste, heightened hearing or nervous deafness, dry eyes.
- frown;
- wrinkle your forehead;
- wrinkle your nose;
- whistle;
- blow out the candle;
- puff out your cheeks;
- take water into your mouth;
- blink both eyes in turn;
- close your eyes (there is a gap on the affected side through which the white of the eye is visible).
Diagnosis of the causes of neuritis of the facial nerve
If you experience signs of facial neuritis, consult a neurologist on the same day. An experienced doctor can make a diagnosis without additional research. But in some cases, instrumental examinations are carried out. This is necessary to identify the cause of nerve inflammation. Neuritis can be caused by tumors, inflammation of the membranes of the brain, and similar symptoms occur with a stroke.Blood analysis
For a general analysis, blood is taken from a finger. Signs of bacterial inflammation that could cause neuritis are:
- significant increase in erythrocyte sedimentation rate;
- increase in the number of leukocytes;
- decrease in the percentage of lymphocytes.
Such results, together with other symptoms (headache, ear discharge, foci of purulent inflammation), may indicate prolonged otitis media, meningitis or other diseases that led to neuritis.
Magnetic resonance imaging (MRI)
Research is based on interaction magnetic field and hydrogen atoms. After irradiation, the atoms release energy, which is recorded by sensitive sensors and allows one to obtain a layer-by-layer image.
The procedure lasts about 40 minutes, its cost reaches 4-5 thousand rubles. This method is considered the most accurate, since the bones of the skull are not an obstacle to the magnetic field. In addition, in this case there is no risk of exposure to x-rays. Therefore, this procedure can be performed even on pregnant women.
MRI can reveal the following signs of the disease:
- brain tumors;
- signs of cerebral infarction;
- abnormal vascular development;
- inflammation of the membranes of the brain.
Computed tomography of the brain CT
The study is based on the properties of tissues that partially absorb X-rays. To obtain accurate information, irradiation is carried out from several points.
During the procedure, you lie down on a couch that moves along a scanner placed in the walls of the tube.
The duration of the procedure is about 10 minutes. This study costs from 3 thousand rubles and is widely distributed.
As a result of the procedure, pathologies that caused neuritis can be detected:
- tumors;
- signs of a stroke;
- plots poor circulation near the nuclei of the facial nerve;
- consequences of head injuries - brain hematomas.
Electroneurography
Study of the speed of propagation of an electrical signal along a nerve. The nerve is stimulated with a weak electrical impulse in one place, and then activity is measured at two other points on its branches. The received data is automatically entered into the computer.
During the procedure, 2 electrodes are placed along the facial nerve. The first one receives weak electrical discharges; you may feel a tingling sensation in this area. The other electrode only picks up the signals. The procedure lasts 15-40 minutes. Cost from 1500 rub.
Signs of the disease:
- a decrease in the speed of impulses - indicates inflammation of the nerve;
- the electrical signal is not transmitted to one of the nerve branches - a rupture of the nerve fiber has occurred
- a decrease in the number of muscle fibers excited by electricity - there is a danger of developing muscle atrophy;
- facial muscles respond weakly to electrical discharges - the conduction of nerve impulses along the trunk is impaired.
This method studies electrical impulses that spontaneously occur in muscles (without stimulation by electrical current). Often the study is carried out together with electroneurography.
During the procedure in different areas Thin disposable needles are inserted into the muscles. At this point you experience short-term pain. Such needle electrodes make it possible to determine the propagation of an impulse in individual muscle fibers. To do this, the technician will first examine your relaxed muscles, and then ask you to frown, puff out your cheeks, and wrinkle your nose. At this moment, electrical impulses arise in the muscles, which are captured by the electrodes. The procedure lasts 40-60 minutes. Cost from 2000 rub.
With neuritis, the following deviations are detected:
- the impulse takes longer to travel through the muscle;
- the number of fibers that respond to the signal decreases.
Treatment of neuritis of the facial nerve
Treatment with medications
| Group of drugs | Representatives | Mechanism therapeutic effect | How to use |
| Diuretics | Furosemide Furon | Accelerate the excretion of urine from the body. Thanks to this, the tissues are freed from edematous fluid. This helps to avoid pressure on blood vessels and swelling of the nerve. | Take 1 tablet 1 time per day. It is advisable to do this in the morning, since urination will be frequent for 6 hours. |
| Nonsteroidal anti-inflammatory drugs | Nise Nurofen | They relieve inflammation along the nerve fiber and help relieve pain in the face and ear. | Take 1 tablet 2 times a day. If necessary, the doctor may increase the dose. Course 10-14 days. |
| Steroid anti-inflammatory drugs - glucocorticoids | Dexamethasone Prednisolone | Relieves inflammation in nerve fibers, swelling and pain. They activate the release of a special substance (neurotransmitter) that improves the conduction of impulses along nerve fibers. People who take glucocorticoids do not experience muscle tightness (contractures). | Take Dexamethasone during or after meals. The first days are prescribed 2-3 mg, after the inflammation subsides, the dose is reduced by 3 times. The course of treatment is up to 10 days. |
| Antiviral agents | Zovirax Acyclovir | They stop the division of the herpes virus, which often causes inflammation of the facial nerve. | Take 1 tablet 5 times a day at regular intervals. It is better to do this during meals with a glass of water. The course of treatment is 5 days. |
| Antispasmodics | No-shpa Spasmol | Relieves spasm of smooth muscles in blood vessels, dilates arteries, improves blood circulation in the inflamed area, and reduces pain. | Take 2 tablets 3 times a day. The course of treatment is up to 2 weeks. |
| Neurotropic agents | Carbamazepine Levomepromazine Phenytoin | Improves the functioning of nerve cells, bringing them back to normal mineral metabolism. They have an analgesic (pain-relieving) effect. Reduce nervous tics and involuntary muscle contractions. Improves the functioning of the nervous system as a whole. | Take half or a whole tablet 2 times a day with a small amount of water. The course of treatment is from 10 days. During this period, refrain from drinking alcohol, otherwise serious adverse reactions may occur. |
| B vitamins | B1, B6, B12 Thiamine, Pyridoxine, Riboflavin | B vitamins are part of nerve cells and their processes. They play an important role in the functioning of the nervous system and protect it from poisoning by toxins. | Take 1-2 tablets after meals, 1 time per day. The course of treatment is 1-2 months. |
| Anticholinesterase drugs | Prozerin Galantamine | They improve the transmission of signals along the nerves to the muscles, increasing their tone. Normalize the functioning of the lacrimal and salivary glands. | Starting from the second week of the disease, 1 tablet is prescribed 1-2 times a day, half an hour before meals. Duration of treatment is 4-6 weeks. If muscle contractures appear, then these drugs are discontinued. |
Remember that treatment of facial neuritis should only be done in a hospital or, with the permission of a doctor, in day hospital. Self-administration of medications can cause serious side effects. In addition, self-medication of neuritis leads to the fact that the facial muscles may never recover.
Physiotherapy for neuritis
Physiotherapeutic treatment can be used only from 7-10 days from the onset of the disease!| Type of physiotherapy | Indications | Mechanism of therapeutic action | How to use |
| Ultrahigh frequency therapy (UHF) of low thermal intensity | Inflammatory process in the facial nerve; Impaired blood circulation and lymph drainage in the inflamed area. | Electric field ultra-high frequency is partially absorbed by tissues. Charged particles penetrate into cells, and this leads to changes in metabolic processes. The tissues heat up, their nutrition improves, and swelling goes away. The number of leukocytes (cells that fight inflammation) increases. | Condenser plates are placed 2 cm above the mastoid process and above the branching point of the facial nerve. Duration 8-15 minutes, course 5-15 sessions daily or every other day. |
| Ultraviolet (UV) irradiation of half or the entire face (1-2 biodoses) | Acute and subacute (from 5-7 days from the onset of the disease) periods of inflammation of peripheral nerves. Diseases of the nervous system that are accompanied by severe pain. | Ultraviolet rays stimulate the production of hormones, various immune cells and immunoglobulins. In this way, an anti-inflammatory and analgesic effect is achieved. | First, the biodose is determined. This irradiation time is necessary for redness with clear boundaries to appear on the skin (1-5 minutes). In the future, the session time is equal to 1-2 biodoses. The course of treatment is 5-20 procedures. |
| Decimeter DMV therapy on the affected side of the face | Acute (not purulent) and subacute inflammatory processes nervous system. | Electromagnetic ultra-high-frequency decimeter waves cause an increase in tissue temperature by 3-4 degrees and activate metabolism. As a result, blood vessels dilate, blood supply improves, and impaired nerve functions are restored. | You are seated on a wooden couch. The emitter is installed so that it barely touches the skin. If the nozzle is pressed tightly, a burn may appear after 1-2 days. Session duration is 5-15 minutes. 3-15 procedures are prescribed for a course of treatment. |
| Electrophoresis medicinal substances- dibazole (0.02%), proserin (0.1%), nivalin, potassium, vitamin B 1 | Inflammatory processes in nerve fibers, Metabolic disorders Weakening (atrophy) of muscles | Action of constant continuous electric current a little force and tension has an anti-inflammatory, decongestant, analgesic, and calming effect. Using current, you can inject the medicine under the skin and achieve a high concentration at the site of inflammation. | Moistened medicinal solution warm flannel pads, and electrodes on top. They are fixed with a rubber band or adhesive tape. After this, the current is gradually added until you feel a slight tingling sensation. The course of treatment is 10-20 procedures, the duration of one is 10-30 minutes. |
| Diadynamic therapy | Muscle paralysis Contractures Pain in the affected half of the face Nerve fiber damage | Pulsed direct currents penetrate the skin into muscle fibers, causing them to contract. This is very important considering that the muscles long time do not work and become weak. They expel fluid, activate enzymes that fight inflammation, and accelerate recovery processes in nerve fibers | Moistened warm water, fabric pads with electrodes. Electrical impulses are applied through them. Depending on the type of current, you will feel pressure, muscle compression, and tingling. The duration of the procedure is 10-20 minutes. It is necessary to undergo 10-30 sessions daily or every other day. |
| Paraffin or ozokerite applications | Subacute period of nerve inflammation Facial paralysis | Such applications have three mechanisms of action: thermal, mechanical (pressure) and chemical (absorption of natural resins). Thanks to this, it is possible to speed up the process of restoration of damaged nerve fibers and get rid of the consequences of inflammation. | On the damaged one and on healthy side On the face, apply heated ozokerite or paraffin in an even layer with a wide brush. When one layer cools, it is covered with a new one. Several layers are covered with oilcloth and woolen cloth. The duration of the procedure is up to 40 minutes. A course of 10-20 procedures daily or every other day. |
During treatment for neuritis of the facial nerve, and especially immediately after physiotherapeutic procedures, beware of hypothermia. This may cause the condition to worsen. After the procedures, it is advisable not to leave the room for 15-20 minutes. And in cold, windy weather outside, wear a hat and cover the affected side of your face with a scarf.
Massage for neuritis of the facial nerve
You can start doing massage for facial neuritis 5-7 days after the first symptoms of the disease appear. It is better to entrust this to an experienced specialist, because massage has some peculiarities. - Before the massage, you need to stretch your neck muscles. To do this, tilt the head back and forth, turn and rotate the head. All exercises are performed 10 times at a very slow pace. Be careful not to get dizzy.
- Begin the massage from the back of the head and neck. In this way, the lymphatic vessels are prepared, because they must receive an additional portion of lymph from the facial part of the head.
- Massage the sore and healthy side of the head.
- Particular attention is paid to the face, mastoid process and neck. The collar area is also kneaded.
- Facial massage should be superficial, especially in the first days. Otherwise, painful muscle contractions may occur.
- Massage with stroking movements, good effect gives a slight vibration.
- Movements are performed along the lymph outflow lines.
- Run your fingers from the middle of the chin, nose and forehead to the parotid glands. Repeat this movement many times.
- Do not massage areas where lymph nodes are located. This can cause them to become inflamed.
- Do this exercise yourself. The thumb of one hand is tucked behind the cheek and the muscles are easily stretched. Big and index fingers the other hand massages the outside of the cheek muscles.
- After the facial massage, the muscles of the back of the head and neck are massaged again to improve the outflow of lymph to the main ducts.
- The massage session ends with exercises for the neck muscles.
Alternative treatment for facial neuritis
Folk remedies for the treatment of neuritis of the facial nerve, they successfully complement the therapy prescribed by the doctor and speed up recovery. We offer several of the most effective recipes.
Facial neuritis requires long-term treatment, so you will notice the first results in about 10 days. But do not despair, if you follow all the doctor’s recommendations, the disease will subside in 3-4 weeks.
Consequences of facial neuritis
Nerve cells recover very slowly after neuritis and are extremely sensitive to stress, hypothermia and toxins. This complicates the treatment process. In addition, some people give up after a few days because they do not see any noticeable improvement. This leads to the fact that they do not accurately follow the doctor’s instructions, skip massages, and refuse to take certain medications. This can lead to serious complications.
- Amyotrophy - muscles decrease in volume and weaken. This happens because the muscles for a long time were inactive, and their nutrition was disrupted. Atrophy irreversible process. It develops about a year after the onset of the disease. To prevent muscle atrophy, do exercises daily, massage and rub your face with baby cream containing fir oil(10 drops of oil per 1 tsp of cream).
- Contracture of facial muscles – tightening of the facial muscles of the affected side, loss of their elasticity. The muscles become painful to the touch and pulsate weakly. This condition develops if improvement does not occur within 4 weeks. In this case, a muscle spasm develops, they shorten and tighten the affected side of the face: the eye looks squinted, the nasolabial fold is clearly visible. Warming (salt, ozokerite), adhesive plaster stickers and massage help prevent this complication.
- Involuntary twitching of facial muscles: facial hemispasm, blepharospasm. Rhythmic contractions of the orbicularis oculi muscle or other facial muscles that are not controlled by a person. The cause is believed to be compression of the facial nerve at the base of the brain by pulsating blood vessels. As a result, the conduction of biocurrents along the nerve is disrupted, and uncontrolled muscle contractions occur. Properly selected drug treatment.
- Facial synkinesis. This complication is due to the fact that the isolation of electrical impulses in the nerve branch is disrupted. As a result, a “short circuit” occurs, and excitation from one area spreads to others along incorrectly grown nerve fibers. For example, when chewing, the lacrimal gland is stimulated, and “ crocodile tears“or when closing an eye, the corner of the mouth rises. To prevent this complication, it is necessary to do self-massage and gymnastics daily.
- Conjunctivitis or keratitis. The inner lining of the eyelids and the cornea become inflamed due to the fact that the person cannot close the eye. In this case, the eyeball is not moistened by tears, it dries out, and dust particles remain on it, which cause inflammation. To avoid this, during illness, use Systane and Oxial drops. At night, cover the eye with a bandage containing Parin moisturizing ointment.
FAQ
What to do to prevent facial neuritis?
It happens that neuritis of the facial nerve occurs again on the same side of the face, then they talk about a relapse of the disease. In this case, longer treatment is required and the chances of recovery are lower. But if you follow preventive measures, a relapse will be avoided. Avoid hypothermia. Scientists have proven that this is the main risk factor. Even small drafts are dangerous. Therefore, avoid being under air conditioning, sitting in transport near open window, do not go outside with a wet head, and in the cold season, wear a hat or put on a hood.
Treat viral diseases in a timely manner. If you feel like you are getting sick, take it right away. antiviral drugs: Groprinosin, Aflubin, Arbidol. You can instill drops with immunoglobulin Viferon into your nose. This will help prevent the virus from reproducing in nerve cells.
Avoid stress. Severe stress weaken immune protection and disrupt the functioning of the nervous system. Therefore, it is advisable to learn how to relieve nervous tension with the help of auto-training and meditation. You can take Glycised, motherwort or hawthorn tincture.
Go to the resort. To consolidate the results of treatment, it is advisable to go to a resort. The dry hot climate of the resorts is ideal: Kislovodsk, Essentuki, Pyatigorsk, Zheleznovodsk.
Eat right. Your nutrition should be complete. The main goal is to strengthen the immune system. To do this, you need to consume a sufficient amount of protein products (meat, fish, cottage cheese, eggs), as well as fresh vegetables and fruits.
Take vitamins. It is very important to consume a sufficient amount of vitamins, especially group B. They take part in the transmission of impulses along nerve cells and are part of their membranes.
Toughen up. Gradual hardening strengthens the immune system, and you become insensitive to hypothermia. Start by taking sun-air baths or simply sunbathing. Take a contrast shower: for the first week, the temperature difference between cold and hot water should be only 3 degrees. Make the water a little colder every week.
Self-massage. For a year, massage your face along the massage lines for 10 minutes, 2 times a day. Place one palm on the healthy side and the other on the sore side. Lower the muscles of the healthy side down, and pull the sick side up. This will help get rid of the residual effects of the previous neuritis and avoid relapse.
Is surgery performed for facial neuritis?
If it is not possible to achieve improvement with the help of medications within 8-10 months, then surgery is prescribed. Surgical treatment of facial neuritis is effective only during the first year of the disease. Then irreversible changes in the muscles begin. Most often, surgery is necessary for ischemic neuritis, when the facial nerve is compressed in the narrow fallopian canal. This happens as a result of prolonged inflammation of the middle ear or a fracture of the skull bones. Surgical treatment is also required for traumatic neuritis of the facial nerve, when the nerve is torn as a result of injury .
Indications for surgery
- nerve rupture due to traumatic neuritis;
- no effect conservative treatment within 8-12 months;
- instrumental studies indicate degeneration of the nerve.
A semicircular incision is made behind the auricle. Find the place where the nerve exits the stylomastoid foramen. The outer wall of the facial nerve canal is removed with a special surgical instrument. This is done very carefully so as not to damage the nerve trunk. As a result, the nerve no longer passes in a “tunnel”, but in an open groove, and the temporal bone stops squeezing it. After this, stitches are applied. The operation is performed under general anesthesia.
Procedure for suturing a torn facial nerve
An incision is made near the auricle. The surgeon finds the torn ends of the nerve under the skin and muscles and “cleans out” the rupture site so that the nerve heals better. Then the surgeon acts according to the circumstances:
- If the distance between the ends of the nerve is no more than 3 mm, then they are sutured. This best option, but it is not always possible to implement it;
- If up to 12 mm of nerve fiber is missing, then it is necessary to free the nerve from the surrounding tissues and lay out a new, shorter course for it. This operation makes it possible to connect the ends of the nerve with one suture, but its blood supply is disrupted;
- Nerve connection using an autograft. A section of the nerve of the required length is taken from the thigh and inserted at the site of the break. In this way, a section several centimeters long can be restored. But in this case, the nerve has to be sutured in 2 places, and this disrupts the transmission of signals.
What gymnastics to perform for neuritis of the facial nerve?
Before gymnastics, do a few exercises to stretch the muscles of your neck and shoulder girdle. Then sit in front of a mirror and relax the muscles on both sides of your face. Perform each exercise 5-6 times. - Raise your eyebrows in surprise.
- Frown your eyebrows angrily.
- Look down and close your eyes. If that doesn't work, lower your eyelid with your finger.
- Squint your eyes.
- Make circular movements with your eyes.
- Smile without showing your teeth.
- Raise your upper lip and show your teeth.
- Lower your lower lip and show your teeth.
- Smile with your mouth open.
- Lower your head and snort.
- Flare your nostrils.
- Puff out your cheeks.
- Move air from one cheek to the other.
- Blow out an imaginary candle.
- Try whistling.
- Pull your cheeks in.
- Push your lips out with a straw.
- Lower the corners of your mouth downwards, lips closed.
- Place your upper lip over your lower lip.
- Move your tongue from side to side with your mouth open and closed.
After the gymnastics, take a scarf, fold it diagonally and secure your face by tying the ends of the scarf at the crown of your head. After this, tighten the facial muscles on the sore side up, and on the healthy side, lower them down.
What does a patient with facial nerve neuritis look like, photo?
Appearance in a person with neuritis of the facial nerve is very characteristic. The face resembles a distorted mask.On the sore side: 
- the eye is wide open;
- the lower eyelid sags;
- lacrimation may occur;
- the outer edge of the eyebrow droops;
- the corner of the mouth is lowered, saliva often oozes from it;
- the mouth will be pulled to the healthy side;
- the cheek muscles are drooping;
- frontal and nasolabial folds are smoothed.
Is acupuncture effective for facial neuritis?
Acupuncture or reflexology is considered one of the most effective methods treatment of neuritis of the facial nerve. Impact on acupuncture points helps:- relieve inflammation in the nerve and speed up its recovery;
- relieve pain;
- get rid of paralysis of facial muscles faster;
- eliminate involuntary twitching of the eyes and lips.
Acupuncture helps restore muscle tone on the affected side of the face and relax the healthy side. Thus, the face becomes more symmetrical from the first days. But remember, the deposit successful treatment- experienced specialist. He must select the necessary techniques and find sensitive points. Disposable needles are used for the procedure, this eliminates the possibility of infection.
Your inner attitude is important for effective treatment. Pay attention to how you feel. You will feel slight pain while the skin is pierced. Then heat or coolness, a feeling of pressure, and tingling will concentrate around the needles. This indicates that the needles are installed in the right places.
From the first days, the disease affects only the healthy side. From 5-7 days you can do acupuncture on the affected side. Many people have become convinced that acupuncture can reduce treatment time by 2 times (up to 2 weeks).
The treatment process for facial neuritis is quite lengthy. You will need to be patient and follow your doctor's recommendations exactly. But remember, there are many effective means treatments that will help you overcome the disease.
Most major nerve, related to the cranial brain, is trigeminal, containing, as the name implies, three main branches and many smaller ones. It is responsible for the mobility of the facial muscles, provides the ability to make chewing movements and bite off food, and also gives sensitivity to the organs and skin of the anterior head area.
In this article we will understand what the trigeminal nerve is.
Layout diagram
The branched trigeminal nerve, which has many branches, originates in the cerebellum, comes from a pair of roots - motor and sensory, and envelops all the facial muscles and some parts of the brain in a web of nerve fibers. The close connection with the spinal cord allows you to control various reflexes, even those associated with respiratory process, for example, yawning, sneezing, blinking.
The anatomy of the trigeminal nerve is as follows: from the main branch, approximately at the level of the temple, thinner ones begin to separate, in turn, branching and thinning further and lower. The point at which separation occurs is called the Gasser, or trigeminal, node. The processes of the trigeminal nerve pass through everything on the face: eyes, temples, mucous membranes of the mouth and nose, tongue, teeth and gums. Thanks to impulses sent by nerve endings to the brain, Feedback providing sensory sensations.
This is where the trigeminal nerve is located.
The finest nerve fibers, literally penetrating all parts of the facial and parietal zones, allow a person to feel touch, experience pleasant or uncomfortable sensations, move the jaws, eyeballs, lips, and express various emotions. Intelligent nature has endowed the nervous network with exactly that amount of sensitivity that is necessary for a calm existence.
Main branches
The anatomy of the trigeminal nerve is unique. The trigeminal nerve has only three branches; from them there is further division into fibers leading to organs and skin. Let's look at them in more detail.
1 branch of the trigeminal nerve is the optic or orbital nerve, which is only sensory, that is, transmitting sensations, but not responsible for the work of motor muscles. With its help, information is exchanged between the central nervous system and nerve cells of the eyes and orbits, sinuses and mucous membrane of the frontal sinus, forehead muscles, lacrimal gland, and meninges.
Three more thinner nerves branch off from the optic one:
- tearful;
- frontal;
- nasociliary.
Since the parts that make up the eye must move, and the orbital nerve cannot provide this, a special autonomic node called the ciliary node is located next to it. Thanks to the connecting nerve fibers and the additional nucleus, it provokes contraction and straightening of the pupillary muscles.
Second branch
The trigeminal nerve on the face also has a second branch. The maxillary, zygomatic or infraorbital nerve is the second major branch of the trigeminal and is also intended to transmit only sensory information. Through it, sensations go to the wings of the nose, cheeks, cheekbones, upper lip, gums and dental nerve cells of the upper row.
Accordingly, from this thick nerve comes a large number of medium and thin branches passing through different parts of the face and mucous tissues and combined for convenience into the following groups:
- maxillary main;
- zygomatic;
- cranial;
- nasal;
- facial;
- infraorbital.
Here, too, there is a parasympathetic vegetative ganglion, called the pterygopalatine ganglion, which promotes salivation and mucus secretion through the nose and maxillary sinuses.
Third branch
The 3rd branch of the trigeminal nerve is called the mandibular nerve, which provides both sensitivity to certain organs and areas and the function of muscle movement. oral cavity. It is this nerve that is responsible for the ability to bite off, chew and swallow food, and encourages the movement of the muscles necessary for speaking and located in all the parts that make up the mouth area.
The following branches of the mandibular nerve are distinguished:
- buccal;
- lingual;
- alveolar lower - the largest, giving off a number of thin nerve processes that form the lower dental ganglion;
- auriculotemporal;
- chewing;
- lateral and medial pterygoid nerves;
- maxillohyoid.
The mandibular nerve has the most parasympathetic formations that provide motor impulses:
- ear;
- submandibular;
- sublingual.
This branch of the trigeminal nerve transmits sensitivity to the lower row of teeth and lower gum, lip and jaw in general. The cheeks also receive sensations partly with the help of this nerve. The motor function is performed by the masticatory, pterygoid and temporal branches.
These are the main branches and exit points of the trigeminal nerve.
Causes of defeat
Inflammatory processes of various etiologies affecting the tissues of the trigeminal nerve lead to the development of a disease called neuralgia. Based on its location, it is also called “facial neuralgia.” It is characterized by a sudden paroxysm of sharp pain piercing different parts of the face.
This is how the trigeminal nerve is damaged.
The causes of this pathology are not fully understood, but many factors are known that can provoke the development of neuralgia.
The trigeminal nerve or its branches are compressed under the influence of the following diseases:
- cerebral aneurysm;
- atherosclerosis;
- stroke;
- osteochondrosis, causing increased intracranial pressure;
- congenital defects of blood vessels and skull bones;
- neoplasms that arise in the brain or on the face where the branches of the nerve pass;
- injury and scarring of the face or jaw joints, temples;
- formation of adhesions caused by infection.
Diseases of viral and bacterial nature
- Herpes.
- HIV infection
- Polio.
- Chronic otitis media, mumps.
- Sinusitis.
Diseases affecting the nervous system
- Meningitis of various origins.
- Epilepsy.
- Encephalopathy, cerebral hypoxia, leading to a lack of supply of substances necessary for full functioning.
- Multiple sclerosis.
Surgery
The trigeminal nerve on the face can be damaged as a result of surgery in the area of the face and oral cavity:
- damage to jaws and teeth;
- consequences of incorrect anesthesia;
- incorrectly performed dental procedures.
The anatomy of the trigeminal nerve is truly unique and therefore this area is very vulnerable.
Characteristics of the disease
The pain syndrome can be felt only on one side or affect the entire face (much less often), and can affect only the central or peripheral parts. In this case, the features often become asymmetrical. Attacks of varying strength last a maximum of a few minutes, but can cause extremely unpleasant sensations.
This is how much discomfort the trigeminal nerve can cause. A diagram of possible affected areas is shown below.
The process can cover different parts of the trigeminal nerve - branches individually or some together, the nerve sheath or its entirety. Most often women aged 30-40 years are affected. Paroxysms of pain in severe neuralgia can be repeated many times throughout the day. Patients experiencing this disease describe the attacks as being like electric shocks, and the pain can be so severe that the person temporarily becomes blind and ceases to perceive the world around him.
Facial muscles can become so sensitive that any touch or movement provokes a new attack. Appear nervous tics, spontaneous contractions of the facial muscles, mild convulsions, discharge of saliva, tears or mucus from the nasal passages. Constant attacks significantly complicate the lives of patients; some try to stop talking and even eating, so as not to further affect the nerve endings.
Quite often, facial paresthesia is observed for a certain time before the paroxysm. This feeling is reminiscent of pain in a sedentary leg - goosebumps, tingling and numbness of the skin.
Possible complications
Patients who delay seeing a doctor run the risk of developing many problems in a few years:
- weakness or atrophy masticatory muscles, most often from trigger zones (areas whose irritation causes painful attacks);
- asymmetry of the face and a raised corner of the mouth, reminiscent of a grin;
- skin problems - peeling, wrinkles, dystrophy;
- loss of teeth, hair, eyelashes, early gray hair.
Diagnostic methods
First of all, the doctor collects a complete medical history, finding out what diseases the patient had to endure. Many of them can provoke the development of trigeminal neuralgia. Then the course of the disease is recorded, the date of the first attack and its duration are noted, and associated factors are carefully checked.
It is necessary to clarify whether paroxysms have a certain periodicity or occur, at first glance, chaotically, and whether there are periods of remission. Next, the patient shows the trigger zones and explains what influences and what force must be applied to provoke an exacerbation. The anatomy of the trigeminal nerve is also taken into account here.
The location of the pain is important - one or both sides of the face are affected by neuralgia, as well as whether painkillers, anti-inflammatory and antispasmodic drugs help during an attack. Additionally, the symptoms that can be described by the patient observing the picture of the disease are clarified.
The examination will need to be carried out both during a quiet period and during the onset of an attack - this way the doctor will be able to more accurately determine the state of the trigeminal nerve, which parts of it are affected, give a preliminary conclusion about the stage of the disease and a prognosis for the success of treatment.
How is the trigeminal nerve diagnosed?
Important Factors
Typically, the following factors are assessed:
- The patient's state of mind.
- Appearance of the skin.
- The presence of cardiovascular, neurological, digestive disorders and pathology of the respiratory system.
- The ability to touch trigger areas on the patient’s face.
- The mechanism of occurrence and spread of pain syndrome.
- The patient's behavior is numbness or active actions, attempts to massage the nerve area and the painful area, inadequate perception of surrounding people, absence or difficulties with verbal contact.
- The forehead becomes covered with sweat, the pain area turns red, heavy discharge from the eyes and nose, swallowing saliva.
- Facial muscle spasms or tics.
- Changes in breathing rhythm, pulse, blood pressure.
This is how the trigeminal nerve is examined.
An attack can be temporarily stopped by pressing on certain nerve points or blocking these points with novocaine injections.
Magnetic resonance and CT scan, electroneurogathia and electroneuromyography, as well as electroencephalogram. Additionally, a consultation with an ENT specialist, neurosurgeon and dentist is usually prescribed to identify and treat diseases that can provoke the appearance of facial neuralgia.
Treatment
Complex therapy is always aimed primarily at eliminating the causes causing disease, as well as to relieve symptoms that cause painful sensations. Typically, the following drugs are used:
- Anticonvulsants: "Finlepsin", "Difenin", "Lamotrigine", "Gabantine", "Stazepin".
- Muscle relaxants: "Baklosan", "Lioresal", "Mydocalm".
- Vitamin complexes containing group B and omega-3 fatty acids.
- Antihistamines, mainly Diphenhydramine and Pipalfen.
- Medicines that have a sedative and antidepressant effect: Glycine, Aminazine, Amitriptyline.
In case of severe lesions of the trigeminal nerve, it is necessary to use surgical interventions, directed:
- to alleviate or eliminate diseases that provoke attacks of neuralgia;
- decreased sensitivity of the trigeminal nerve, a decrease in its ability to transmit information to the brain and central nervous system;
As additional methods The following types of physiotherapy are used:
- irradiation of the neck and face area with ultraviolet radiation;
- exposure to laser irradiation;
- treatment using ultra-high frequencies;
- electrophoresis with drugs;
- Bernard diadynamic current;
- manual therapy;
- acupuncture.
All treatment methods, medications, course and duration are prescribed exclusively by the doctor and are selected individually for each patient, taking into account his characteristics and the picture of the disease.
We looked at where the trigeminal nerve is located, as well as the causes of its damage and treatment methods.
Facial nerve, the seventh pair of thirteen cranial nerves. Enhances sensitivity to the facial muscles. The topography follows from the nuclei to the muscles, from the opening of the auditory apparatus it passes to the temporal bone. It then flows into the internal auditory canal and the facial nerve tunnel. From the temporal bone strive to the parotid gland. Then it is split into small processes, they transmit sensitivity to the forehead, wings of the nose, cheekbones, as well as the circular muscles of the eyes and mouth.
The anatomy of the nervous system is quite complex and tortuous. The nerve trunk comes from processes covered with a special tissue - neuroglia. When neuroglia are damaged, the symptoms do not manifest themselves very acutely, compared to infringement or damage to the neuroglia itself.
The facial nerve consists of:
- areas of the cerebral cortex responsible for the work of facial muscles;
- Nuclei are located between the medulla oblongata and the bridge. There are three nuclei responsible for facial expressions; nucleus of the solitary tract regulatory
salivation endings giving taste sensations, corrects the salivary glands;
- directly the nerve trunk, or rather its processes;
- capillary network and lymph nodes, due to which the nerve cells are nourished.
Also, facial sensitivity occurs due to the fact that the trigeminal nerve is located nearby. The ophthalmic branch is derived from the trigeminal. Basically, it serves as a sensory transmitter, that is, it transmits data from various receptors. Thinner nerve branches also diverge from the ophthalmic branch and innervate the orbit. Accordingly, the orbital fissure is supplied by the innervation of the trigeminal, and from it, in turn, branches extend to the frontal, lacrimal and nasociliary.
The maxillary branch also consists only of sensitive cells and transmits information from receptors. In the orbit itself, this branch branches, entering there through the lower palpebral fissure. The maxillary branch throws off the nerve maxillary plexus; its main task is the interaction of the nervous system with the receptors of the gums and teeth. As soon as the maxillary nerve fibers pass into the infraorbital region, innervation of the eyelid immediately occurs. And only one single branch regulates the sensitivity of the cheekbones and cheeks - this is the zygomatic nerve, which subsequently enters through the superior fissure into the orbit itself.
The mandibular branch, unlike those listed above, not only carries information between the central nervous system and nerve cells, but also carries out motor function. This is a large branch, starts from the oval foramen and immediately gives off three branches. Sensitivity is applied to the gums, dental nerve endings of the lower jaw and cheeks. The pterygoid, masticatory and temporal branches are responsible for motor functions.
Functions
The most basic task of the facial nerve is motor function. Before branching into small parts, it is intertwined with the intermediate one, and performs some of the duties together with it. Through the internal auditory opening they tend to the tunnel of the facial nerve. After this, the genu begins to form, which provides sensory input to the intermediate nerve.
Coming from the parotid gland, the branches of the facial nerve are divided into powerful superior and more graceful inferior. They also branch into smaller processes. Which create the parotid plexuses, then the nerve provides motor activity almost all facial muscles. But although this function is the main one, due to the intermediate nerve, it has secretory and taste fibers.
Intermediate, located in the thickness of the temporal bone, throws off nerve spines: large stony, stirrup, branches connecting it and a tympanic plexus, all this ends with a tympanic string.
Clinical lesions
If a malfunction occurs or the facial nerve canal is pinched, this can lead to paralysis of the motor facial muscles. Facial asymmetry is visually diagnosed. The part of the face that is relaxed and motionless creates a mask effect, the eye does not close on the affected side, and lacrimation increases. It occurs due to irritation of the eye mucosa by air and dust, therefore leading to inflammation and conjunctivitis. Wrinkles on the forehead and nasolabial area are straightened. The corners of the mouth “look” down; the victim cannot wrinkle his forehead on his own. Paralysis of the orbicularis oculi muscle and the non-adjacent part of the eyelid to the eyeball lead to disruption of the formation of the capillary gap. Because of this, problems with tear production occur.
Peripheral lesions
If for some reason motor function is affected, then we can talk about peripheral paralysis. The clinical manifestations are as follows: complete asymmetry of the face, paralysis of facial muscles, limited intake of liquids, impaired speech apparatus. If damage to the nerve occurs when it is located in the pyramidal bone, then the following is observed: absence of taste symptoms, deafness and all of the above symptoms are observed.
Neuritis
A neurological disease characterized by inflammation. Neuritis can be located in the central part of the face and in the peripheral part. Symptoms depend on which part of the nerve is involved. As a rule, there are no erroneous diagnoses in differentiation and formulation. The development of the disease can be due to hypothermia, the so-called primary neuritis, and secondary, manifested due to some other diseases.
The clinical picture is described acute onset. The pain radiates behind the ear, and after a few days, facial asymmetry is noticeable. Symptoms may vary, depending on the affected part. If the nucleus of the facial nerve is affected, then the person suffers from facial muscle weakness. The process of infringement located in the area of the pons of the brain leads to strabismus and paralysis of almost all facial muscles. If infringement occurs at the exit, this can lead to impairment and short-term hearing loss.
Neuritis may be concomitant, for example, with chronic otitis media. And it arises due to the ongoing process of inflammation in the middle ear. Therefore, facial paresis occurs with accompanying “shooting” in the ear. When accompanied by mumps, general intoxication of the body occurs - fever, chills, body aches.
The treatment regimen for inflammation and injuries should be comprehensive and timely. Drug therapy necessarily includes:
- glucocorticosteroid drugs;
- diuretics that remove fluid from the capillary network;
- drugs that promote vasodilation;
- vitamin therapy, usually group B.
Further, complex treatment of this nerve includes exclusion and treatment of the underlying cause. Since neuralgia is the result of an illness or a secondary disease. Usually nervous diseases are accompanied by quite painful sensations, to reduce or stop them, they are prescribed analgesics. For more efficient and quick treatment, the facial muscles should remain completely at rest. Physiotherapeutic measures are also adjacent to complex treatment. From the second week of the diagnosed disease, you can include facial massages and physical therapy. In this case, the load increases gradually.
Surgical intervention is performed in rare cases, if neuralgia is congenital or the nerve is severely damaged due to mechanical injury. This operation involves stitching together torn or incorrectly fused ends. Another incident that provokes surgical intervention– this is the ineffectiveness of drug therapy for 6-8 months. If you do not resort to such treatment methods or strongly start the disease process, this leads to complete atrophy of the facial muscles, which can no longer be restored. You can also resort to surgical plastic surgery face, the material for this is taken from the leg of the person being operated on.
Forecast
When contacting medication assistance and proper treatment, the process of recovery and restoration is quite long, but at the same time favorable. The burden also depends on concomitant diseases. Relapses can be successfully treated, but are much more severe and take longer to resolve.
To avoid these pathologies, you should take care of your health, do not overcool the body, and promptly treat various inflammatory processes, such as ARVI, influenza, and sore throat.
Facial nerve (intermediate facial nerve), n. facialis (n. intermediofacialis) (VII pair) , - mixed nerve.
Facial nerve nucleus nucleus n. facialis, lies in the central part of the bridge, in the reticular formation, somewhat posterior and outward from the nucleus of the abducens nerve.
From the side of the rhomboid fossa, the nucleus of the facial nerve projects lateral to the facial tubercle.
The processes of the cells forming the nucleus of the facial nerve first follow in a dorsal direction, bending around the nucleus of the abducens nerve, then, forming the genu of the facial nerve, genu n. facialis, are directed ventrally and exit onto the lower surface of the brain at the posterior edge of the pons, above and lateral to the olive of the medulla oblongata.
The facial nerve itself is motor, but after the attachment of the intermediate nerve, n. intermedius, represented by sensory and vegetative fibers (gustatory and secretory), acquires a mixed character and becomes interfacial nerve.
The nucleus of the intermediate nerve is the superior salivary nucleus, nucleus salivatorius superior, - the autonomic nucleus, lies somewhat posterior and medial to the nucleus of the facial nerve.
The axons of the cells of this nucleus make up the bulk of the intermediate nerve.
At the base of the brain, the intermediate nerve appears along with the facial nerve. Subsequently, both nerves, together with the vestibulocochlear nerve (VIII pair), enter through the internal auditory opening of the petrous part (pyramid) of the temporal bone into the internal auditory canal.
Here the facial and intermediate nerves connect and through the field of the facial nerve, area n. facialis, enter the facial nerve canal. At the point where this canal bends, the facial nerve forms a genu, geniculum n. facialis, and thickens due to the ganglion geniculi.
Facial nerve, n. facialis,
and tympanic nerve, n. tympanicus;
This node belongs to the sensitive part of the intermediate nerve.
The facial nerve follows all the curves facial canal and, leaving the pyramid through the stylomastoid foramen, lies in the thickness of the parotid gland, where it divides into its main branches.
Facial nerve, n. facialis
Inside the pyramid, a number of branches depart from the interfacial nerve:
1. Greater petrosal nerve, n. petrosus major, begins near the genu ganglion and consists of parasympathetic fibers of the intermediate nerve.
It leaves the pyramid of the temporal bone through the cleft of the canal of the greater petrosal nerve, lies in the groove of the same name and exits the cranial cavity through the lacerated foramen.
Subsequently, this nerve, passing through the pterygoid canal of the sphenoid bone, in which, together with the sympathetic nerve, forms the nerve of the pterygoid canal, n. canalis pterigoidei, enters the pterygopalatine fossa, reaching the pterygopalatine node.
2. Connecting branch with the tympanic plexus, r. communicans (cum plexu tympanico), departs from the genu ganglion or from the greater petrosal nerve and approaches the lesser petrosal nerve.
3. Stapedial nerve, n. stapedius, is a very thin branch that starts from the descending part of the facial nerve, approaches the stapedius muscle and innervates it.
4. Connecting branch with vagus nerve, r. communicans (cum nerve vago),- thin nerve, approaches the lower node of the vagus nerve.
5. Drum string, chorda tympani, is the terminal branch of the intermediate nerve. It departs from the trunk of the facial nerve slightly above the stylomastoid foramen, enters the tympanic cavity from the posterior wall, forming a small arch, concavely facing downwards, and lies between the handle of the malleus and the long leg of the incus.
Approaching the petrotympanic fissure, the chorda tympani leaves the skull through it. Subsequently, it is directed downwards and, passing between the medial and lateral pterygoid muscles, enters the lingual nerve at an acute angle. In its course, the chorda tympanum does not give off branches; only at the very beginning, after leaving the skull, it is connected by several branches to the ear node.
The chorda tympani consists of two types of fibers: prenodular parasympathetic, which are processes of the cells of the superior salivary nucleus, and gustatory fibers, which are peripheral processes of the cells of the genu ganglion. The central processes of these cells end in the nucleus of the tractus solitarius.
Some of the fibers of the chorda tympani, which are part of the lingual nerve, are directed to the submandibular and sublingual nodes as part of the nodal branches of the lingual nerve (centrifugal fibers), and the other part reaches the mucous membrane of the back of the tongue (centripetal fibers - processes of the cells of the genu ganglion).
Facial nerve canal.
Having emerged through the stylomastoid foramen from the pyramid of the temporal bone, the facial nerve, even before entering the thickness of the parotid gland, gives off a number of branches:
1. Posterior auricular nerve, n. auricularis posterior, begins directly below the stylomastoid foramen, turns posteriorly and upward, goes behind the external ear and divides into two branches: the anterior auricular branch, r. auricularis, and the posterior - occipital branch, r. occipitalis.
The auricular branch innervates the posterior and superior auricular muscles, the transverse and oblique muscles of the auricle, and the antitragus muscle.
The occipital branch innervates the occipital belly of the supracranial muscle and connects with the greater auricular and lesser occipital nerves of the cervical plexus and with the auricular branch of the vagus nerve.
2. Stylohyoid branch, r. stylohyoideus, may arise from the posterior auricular nerve. This is a thin nerve that goes downwards, enters the thickness of the muscle of the same name, having previously connected with the sympathetic plexus located around the external carotid artery.
3. Digastric branch, r. digastricus, can arise from both the posterior auricular nerve and the trunk of the facial nerve. It is located slightly below the stylohyoid branch, descends along the posterior belly of the digastric muscle and gives branches to it. It has a connecting branch with the glossopharyngeal nerve.
4. Lingual branch, r. lingualis, non-permanent, is a thin nerve that bends around the styloid process and passes under the palatine tonsil. It gives off a connecting branch to the glossopharyngeal nerve and sometimes a branch to the styloglossus muscle.
Having entered the thickness of the parotid gland, the facial nerve is divided into two main branches: the more powerful upper and smaller lower. These branches are further divided into second-order branches, which diverge radially: up, forward and down to the facial muscles.
Between these branches in the thickness of the gland, connections are formed that make up the parotid plexus, plexus parotideus.
The following branches of the facial nerve depart from the parotid plexus:
1. Temporal branches, rr. temporales: back, middle and front. They innervate the superior and anterior auricular muscles, the frontal belly of the supracranial muscle, the orbicularis oculi muscle, and the corrugator muscle.
2. Zygomatic branches, rr. zygomatici, two, sometimes three, are directed forward and upward and approach the zygomatic muscles and the orbicularis oculi muscle.
3. Buccal branches, rr. buccales, are three or four fairly powerful nerves. They arise from the upper main branch of the facial nerve and send their branches to the following muscles: the zygomaticus major, the laughter muscle, the buccal muscle, the levator and depressor of the upper and lower lips, the levator and depressor of the angle of the mouth, the orbicularis oris muscle and the nasal muscle. Occasionally, there are connecting branches between the symmetrical nerve branches of the orbicularis oculi muscle and the orbicularis oris muscle.
4. Marginal branch of the lower jaw, r. marginalis mandibulae, moving anteriorly, it runs along the edge of the lower jaw and innervates the muscles that lower the angle of the mouth and the lower lip, the mental muscle.
5. Cervical branch, r. colli, in the form of 2-3 nerves it goes behind the angle of the lower jaw, approaches the subcutaneous muscle, innervates it and gives off a number of branches connecting with the upper (sensitive) branch of the cervical plexus.
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